[Karen W. (OP)]

They have come down but are still higher then she said she would like but she explained nothing other then I could have another one...Heart attack that is.. this is the third one now since 2006.. so  far no damage but this last one she said was more severe as far as the heart muscle and it seems to be more sluggish...I am on blood thinners and am waiting for the 2oth to be reevaluated in Stanford.. seems they are still baffled here..

So I understand that the enzymes are markers of a type and can help in diagnosis etc with the heart attack.. So They are sending me back to Standford on the 20th to re-evaluate the aneurysms.. She thinks they are basically, at least the upper aorta one is the concern..It  is Larger.. is causing problems... with oxygen supply and wants the cardiologists to do more checking...

How the heck can that cause trouble with oxygen supply...? It makes no sense to me? The high blood pressure causes the expansion of the aneurysm, sending the blood to the left ventricle, which is flawed, and cannot deal with the higher volume blood flow, so it gushes back into the valve, regurgitating and clotting in the valve. I would think that the expansion or volume, would cause more oxygenated blood to be pumped into the heart, does it not....? Not good for the aneurysm or me, but how does it impede oxygen to the heart?

Could someone explain.. so I understand.. I tried to look it up, but cannot find anything relevant to explain what she means, or how that could be???

Thanks Guys...

[RD]

Heart attacks and aneurysms can be associated: both can be consequences of vascular disease ...

Systemic vascular disease can cause high blood pressure, (hypertension), which in turn can cause aneurysm.

Vascular disease in the blood vessels supplying the heart muscle, (coronary arteries), reduces the blood supply to the heart muscle producing angina, or a heart attack.

The aneurysm makes the aorta expand and pumps more blood into the heart does it not....? Not good for the aneurysm or me, but how does it impede oxygen to the heart?

If the aneurysm is very close to the aortic valve it could affect the competency of the valve, resulting in regurgitation, and reduced circulation, (reduced cardiac output). This would reduce the flow of oxygenated blood to everything, including coronary arteries.

[Karen W. (OP)]

 The problem with the vascular disease is that they said my arteries are clear except at the valves where the regurgitation is happening.. and they said they are all leaking pretty good.It has been about three weeks ago that I had a heart attack.. which I thought was a bad case of angina and I treated it with my nitroglycerin as I always do, except this time the pain eased after a couple doses but, I got extremely weak and nauseated and sick.. felt horrible for three days.. was feeling really bad again went in to doctor and she said I was had a heart attack so then she started taking blood draws to check Cardiac enzymes they remained very high but started coming down over the next couple days.. now she says they are still higher then they should be and that it is indicative of another possible heart attack to come... so I want to learn more about cardiac enzymes, I understand they are markers, but if they don't come down, does it necessarily mean I am definitely going to have another one very soon...Are there statistics to that fact RD?

The ascending aneurysm is right next to the valve in the arch and has been in regurgitation mode for a few years now.. at first slight but over the years it has become a lot worse.. I just did not understand how that would lower the oxygen input to the heart? My doctor tried to explain but I did not understand... I have another in the descending end.. at about a 4.0 The upper one is at 5+ at this point.. we will see just how much over 5 on the 20th at Standford.

So I am assuming that with vascular disease you mean that the calcification and cholesterol build up will block the oxygen flow into the heart right? But since I have great cholesterol levels and no clogging in my arteries, then how would the aneurysm block off blood flow? There is very little plaque around the valves and yet they are all regurgitating.. he said I have a left ventricle.. malfunction of a sort.. and it is not able to handle the amount of blood flow when the Aorta valve regurgitates.. they said it backs back up into the left ventricle if I understood him correctly.. the valves have been very noisy the last many times they have done the Echo's.. So are there other things that can cut off the flow.. or are those troubles alone most likely the reason? It seems so confusing..

[RD]

The ascending aneurysm is right next to the valve in the arch and has been in regurgitation mode for a few years now.. at first slight but over the years it has become a lot worse.. I just did not understand how that would lower the oxygen input to the heart?

If the aneurism is close to the aortic valve it can cause the diameter of the valve to get bigger and the cusps in the valve (which don't get bigger) no longer form a complete seal which then allows some blood to flow the wrong way (regurgitation). Regurgitation reduces the blood flow to everthing, including the heart muscle.

About half of the cases of aortic [valve] insufficiency are due to the aortic root dilatation (annuloaortic ectasia)

  http://en.wikipedia.org/wiki/Aortic_regurgitation#Etiology

There is very little plaque around the valves and yet they are all regurgitating.

Inflammatory diseases (caused by immune system) can be a cause of heart valve damage and aneurisms, e.g. ...

Behçet's disease, ankylosing spondylitis, systemic lupus erythematosus, and various [other] collagen vascular diseases

http://en.wikipedia.org/wiki/Aortic_regurgitation#Etiology

I want to learn more about cardiac enzymes

 
My understanding is that cardiac enzymes are raised in the hours after a heart attack …

Depending on the marker, it can take between 2 to 24 hours for the level to increase in the blood. Additionally, determining the levels of cardiac markers in the laboratory - like many other lab measurements - takes substantial time. Cardiac markers are therefore not useful in diagnosing a myocardial infarction in the acute phase. The clinical presentation and results from an ECG are more appropriate in the acute situation.

http://en.wikipedia.org/wiki/Cardiac_marker#Limitations

[Karen W. (OP)]

So is that why they do so many blood workups for the first day and a half or 2 after the heart attack..? She said she was keeping an eye on the enzymes...So they already diagnosed the heart attack but after monitoring the enzymes for a while, I want to know what the enzyme information does for them after that? I understand they go up following the heart attack but does that not mean that checking the enzymes are also a way for them to verify the attack.. or are they used for future treatment also?